Early Placement of Postpartum Hemorrhage control Devices improves Outcomes: Study

The research employed a standardized three-stage postpartum hemorrhage response protocol. Hemorrhage-control devices were used in stage 2 or 3 of the protocol. Quantitative blood loss was quantitated, and the proportions of blood transfusion, utilization of 3 or more RBC units, and device failure were compared.

Key Findings

• The median quantitative blood loss during device placement was 194 mL (67–440 mL) for intrauterine balloon tamponade and 240 mL (113–528 mL) for vacuum-induced devices (P=0.40).

• Packed RBC transfusion rates were 59.7% for balloon tamponade and 50.0% for vacuum devices (P=0.08).

• 3 or more RBC units transfusion was 27.0% of tamponade cases and 24.9% of vacuum device cases (P=0.53).

• Failure rates for devices were 7.7% for tamponade and 8.5% for vacuum (P=0.70).

• Preceding device insertion at blood loss of 1,000–1,499 mL decreased RBC transfusion rates (39.1% vs 70.3%, P<.001), requirement for 3 or more RBC units (13.7% vs 38.1%, P<.001), and device failure (3.4% vs 12.9%, P<0.001).

The study authors concluded that prior placement of hemorrhage-control devices during postpartum hemorrhage greatly reduces blood transfusion needs and device failure. Both intrauterine balloon tamponade and vacuum-induced devices worked, but timing is all about maximizing outcomes.

Reference:

Shields, Laurence E. MD; Klein, Catherine MSN, RN; Torti, Jennie MPH; Foster, Mindy MSN, RN; Cook, Curtis MD. Effectiveness of the Intrauterine Balloon Tamponade Compared With an Intrauterine, Vacuum-Induced, Hemorrhage-Control Device for Postpartum Hemorrhage. Obstetrics & Gynecology 145(1):p 65-71, January 2025. | DOI: 10.1097/AOG.0000000000005770